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File numbers 4874 - 5509, 1926-1930

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Form 2213 PRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN 5042 U. S. DEPARTMENT OF LABOR NOT TO BE FILLED IN BY ALIEN FOR USE OF OFFICIALS SEARCHING IMMI- NATURALIZATION SERVICE GRATION RECORDS CLERK OF COURT: RECORDS EXAMINED Place number in CARD INDEX upper left-hand corner of all copies of declaration, immediately under your INDEX BOOKS declaration number. DISTRICT DIRECTOR OF NATURALIZATION MANIFESTS I desire to Mr. file my Decl SMUE Zention Policisty (infst paper) to become Polonsky a citizen. My name is Mrs. Summe (Alien should print or typewrite Folonshy here true, original, and correct ; age, 27 years. Miss name) (Give age last birthday) My present occupation is Farmar My personal description is: Color, white complexion, dark ; height, 5 feet 934 inches; weight, 158 pounds; color of hair, black ; color of eyes, darkbrown other visible distinctive marks: none I was born in Bialistock , Anssia now Poland (City rotn) (Country) on the 9 day of august 1899 My present residence is Sushold 1. new London, Com (Number and street) (City or town) (County) (State) The place where I took the ship train which landed in the United States antwayp or me was Belgium on Jun (Month) 15. 1910. (Day) (Year) The name of the ship or railroad on which I came was My last place of foreign residence was said Bialistich Russia Finland (City or town) (Country) I am nowmarried. The name of my { wife is Panlina Glady She was born at husband He Russia , and now resides at said Sisnold newsland Com I am now a subject of and intend to renounce allegiance to Poland (Write name and title of sovereign and country of which now a subject; or, if citizen of a republic, write name of republic only) I arrived at the United States immigration port of Stellis Island (City or town) new find (State or territory) (OVER) , Jan on 14-8 (Give 26,19100 exact month, day, and year)

Page data

Page
337
Source index
0
Type
photo
Media ID
cb97e56603fbb37b
Size
unknown

Document data

ID
159596813
Core
doc
Type
document
DTO data 
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Context sent to Scholar

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    "ocrText": "Form 2213\nPRELIMINARY FORM FOR DECLARATION OF INTENTION TO BECOME A CITIZEN\n5042\nU. S. DEPARTMENT OF LABOR\nNOT TO BE FILLED IN BY ALIEN\nFOR USE OF OFFICIALS SEARCHING IMMI-\nNATURALIZATION SERVICE\nGRATION RECORDS\nCLERK OF COURT:\nRECORDS EXAMINED\nPlace number\nin\nCARD INDEX\nupper left-hand corner of all copies of\ndeclaration, immediately under your\nINDEX BOOKS\ndeclaration number.\nDISTRICT DIRECTOR OF NATURALIZATION\nMANIFESTS\nI\ndesire to Mr. file my Decl SMUE Zention Policisty (infst paper) to become Polonsky a citizen.\nMy name is\nMrs.\nSumme (Alien should print or typewrite Folonshy here true, original, and correct\n;\nage, 27\nyears.\nMiss\nname)\n(Give age last birthday)\nMy present occupation is\nFarmar\nMy personal description is: Color, white complexion, dark\n; height, 5 feet 934 inches;\nweight, 158 pounds; color of hair, black\n;\ncolor of eyes, darkbrown\nother visible distinctive marks: none\nI was born\nin Bialistock , Anssia now Poland\n(City rotn)\n(Country)\non the 9\nday\nof august\n1899\nMy present residence is\nSushold 1. new London, Com\n(Number and street)\n(City or town)\n(County)\n(State)\nThe place where I took the ship train which landed in the United States antwayp\nor me was\nBelgium\non Jun (Month)\n15.\n1910.\n(Day)\n(Year)\nThe name of the ship or railroad on which I came was\nMy last place of foreign residence was\nsaid Bialistich Russia\nFinland\n(City or town)\n(Country)\nI am nowmarried. The name of my\n{\nwife\nis\nPanlina Glady\nShe\nwas born at\nhusband\nHe\nRussia\n, and now resides at\nsaid Sisnold newsland Com\nI am now a subject of and intend to renounce allegiance to\nPoland\n(Write name and title of sovereign and country of which now a subject;\nor, if citizen of a republic, write name of republic only)\nI arrived at the United States immigration port of\nStellis Island (City or town) new find\n(State or territory)\n(OVER)\n, Jan on 14-8 (Give 26,19100 exact month, day, and year)"
}